2025 Teens Summer Camp Application

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Teens (Age 12* - 16) July 6th – July 10th
*12 year olds must be finishing 7th grade and have been coming to teens service to register for teens camp.

Camp Location:
Conference & Retreat Center
5605 Jubilee Dr SE, Turner, OR 97392

If you have any questions please call:
Stanislav Velichko (503) 805-3599
Dennis Panfilov (360) 513-7929

Instructions:
1. Complete form by May 17th
2. Provide payment information: $150 per child
3. Submit a separate form per child

Notes:
School buses will be used for transporting teens to and from campsite.

Please note: our summer camps are for members only, there will be no refunds if the applicant's parents are non-members.

Name

Please Upload a Profile Photo

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Address

Gender

Male Female

Date of Birth

Age at time of camp

12 13 14 15 16

T-Shirt Size

XSmall Small Medium Large XLarge

Father's Name

Father's Phone Number

Mother's Name

Mother's Phone Number

Emergency Contact & Phone Number

What church are the parents of the applicant members of?

Sulamita Other

If other, please provide the name:

Does applicant have allergies to any medications?

None Claritin Visine (eye drops) Tylenol Ibuprofen Benadryl Other

If yes, please specify:

Does applicant have any seasonal/other allergies?

Yes No

If yes, please specify:

Will your child bring any medications from home?

Yes No

If yes, please specify:

Specify any special conditions or needs staff needs to be aware of

None Health/Physical/Medical Eating Sleeping Swimming Other

If there are any please elaborate:

Camp Waiver Link Doc

Electronic Signature (Participant's Full Name or Full Name of Legal Guardian if Participant is Under the Age of 18)

This address will receive a confirmation email

Teens Camp Registration

Please consider donating to "Teens Ministry" to help support families that are not able to cover registration for all their children. Click here to donate in a new window.

Credit/Debit Card Number

Expiration Date/CVC

Name on Card Card Billing Address

2025 Teens Summer Camp Application

Description

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